Cent Eur J Public Health 2019, 27(3):175-181 | DOI: 10.21101/cejph.a5796

FCTC implementation: the role of state or non-government organizations? An example of the Czech Republic

Keely G. Fraser1, Alexandra Pánková1,2, Kamila Zvolská2, Eva Králíková1,2
1 Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
2 Centre for Tobacco-Dependent, 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

Objectives: Smoking is the leading cause of premature mortality and morbidity. The aim of this study was to provide the first national description of organizational capacity and involvement in tobacco control (TC) measures outlined by the WHO Framework Convention on Tobacco Control (FCTC) within the Czech Republic.

Methods: Data were collected in a national cross-sectional survey of all 14 organizations engaged in TC activities within the Czech Republic. Organizational capacity (defined as skills, supports, partnerships, resources, and leadership) to implement TC activities, and level of involvement in key FCTC measures were assessed and compared across organizations.

Results: Despite the high economic costs of tobacco use, few organizations were involved in TC activities. 50% of all organizations involved in TC activities were non-government or non-profit organizations. Less than one third of organizations reported having a sufficient number of staff or adequate funding to work effectively. Skills for chronic disease prevention (CDP) practice including assessment, identifying relevant practices, developing and implementing initiatives were rated more favourably than skills to evaluate these activities. Level of involvement was ranked highest for activities that focused on creation of smoke-free environments and lowest for activities that focused on raising taxes and sales to minors. Organizations tended to be more involved in individual, rather than population-level prevention strategies. Inadequate funding, insufficient number of staff dedicated to working on TC, and lack of political will were major barriers.

Conclusions: This paper provides the first national description of organizational capacity and level of involvement in FCTC measures within the Czech Republic.

Keywords: FCTC, tobacco control, capacity assessment, smoking, public health

Received: April 23, 2019; Revised: August 30, 2019; Accepted: August 30, 2019; Published: September 30, 2019  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Fraser KG, Pánková A, Zvolská K, Králíková E. FCTC implementation: the role of state or non-government organizations? An example of the Czech Republic. Cent Eur J Public Health. 2019;27(3):175-181. doi: 10.21101/cejph.a5796. PubMed PMID: 31580550.
Download citation

References

  1. World Health Organization. WHO report on the global tobacco epidemic, 2015: raising taxes on tobacco. Geneva: WHO; 2015.
  2. World Health Organization. Data and statistics [Internet]. Geneva: WHO; 2019 [cited 2019 Aug 30]. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/tobacco/data-and-statistics.
  3. Váňová A, Skývová M, Malý M. Tobacco abuse in the Czech Republic in 2017. Prague: NIPH; 2018.
  4. Joossens L, Raw M. The Tobacco Control Scale 2013 in Europe. Brussels: ECL; 2014.
  5. American Cancer Society; Vital Strategies. Czech Republic: fact sheet [Internet]. ACS; 2019 [cited 2019 Aug 30]. Available from: https://tobaccoatlas.org/wp-content/uploads/pdf/czech-republic-country-facts.pdf.
  6. Peto R, Lopez AD, Pan H, Boreham J, Thun M. Mortality from smoking in developed countries 1950-2020 [Internet]. 2015 [cited 2019 Aug 30]. Available from: http://gas.ctsu.ox.ac.uk/tobacco/C0002.pdf.
  7. Organization for Economic Co-operation and Development. Caring for quality in health: lessons learnt from 15 reviews of health care quality. Paris: OECD; 2017.
  8. World Health Organization. Framework for country action across sectors for health and health equity: WHO Discussion Paper [Internet]. Geneva: WHO; 2014 [cited 2014 Oct 29]. Available from: http://www.who.int/nmh/events/framework-discussion-paper-rev.pdf.
  9. Christensen T, Lægreid P, editors. Autonomy and regulation: coping with agencies in the modern state. Cheltenham: Edward Elgar Publishing; 2006. Go to original source...
  10. World Health Organization. WHO Framework Convention on Tobacco Control. Geneva: WHO; 2003.
  11. World Health Organization. WHO Report on the Global Tobacco Epidemic, 2008: the MPOWER package. Geneva: WHO; 2008.
  12. Smith C, Raine K, Anderson D, Dyck R, Plotnikoff R, Ness K, et al. A preliminary examination of organizational capacity for heart health promotion in Alberta's regional health authorities. Promot Educ. 2001;Suppl 1:40-3.
  13. McLean S, Ebbesen L, Green K, Reeder B, Butler-Jones D, Steer S. Capacity for community development: an approach to conceptualization and measurement. J Community Dev Soc. 2001;32(2):251-70. Go to original source...
  14. Taylor SM, Elliott S, Riley B. Heart health promotion: predisposition, capacity and implementation in Ontario public health units, 1994-96. Can J Public Health. 1998;89(6):410-4. Go to original source...
  15. Joffres C, Heath S, Farquharson J, Barkhouse K, Latter C, MacLean DR. Facilitators and challenges to organizational capacity building in heart health promotion. Qual Health Res. 2004;14(1):39-60. Go to original source... Go to PubMed...
  16. Hanusaik N, O'Loughlin JL, Kishchuk N, Eyles J, Robinson K, Cameron R. Building the backbone for organisational research in public health systems: development of measures of organisational capacity for chronic disease prevention. J Epidemiol Community Health. 2007;61(8):742-9. Go to original source... Go to PubMed...
  17. Frieden TR. A framework for public health action: the health impact pyramid. Am J Public Health. 2010 Apr;100(4):590-5. Go to original source... Go to PubMed...
  18. Mereu A, Sotgiu A, Buja A, Casuccio A, Cecconi R, Fabiani L, et al. Professional competencies in health promotion and public health: what is common and what is specific? Review of the European debate and perspectives for professional development. Epidemiol Prev. 2015;39(4 Suppl 1):33-8.
  19. Page SE. The Difference: how the power of diversity creates better groups, firms, schools, and societies. Princeton: Princeton University Press; 2008. Go to original source...
  20. McDonald PW, Viehbeck S. From evidence-based practice making to practice-based evidence making: creating communities of (research) and practice. Health Promot Pract. 2007 Apr;8(2):140-4. Go to original source... Go to PubMed...
  21. World Health Organization. Assessment of national capacity for noncommunicable disease prevention and control: the report of a global survey. Geneva: WHO; 2001.
  22. Kinkorová J, Topolčan O. Overview of healthcare system in the Czech Republic. EPMA J. 2012;3(1):4. doi: 10.1007/s13167-012-0139-9 Go to original source... Go to PubMed...
  23. OECD Reviews of Health Care Quality: Czech Republic 2014: raising standards [Internet]. Paris: OECD; 2014 [cited 2019 Aug 30]. Available from: http://dx.doi.org/10.1787/9789264208605-en. Go to original source...
  24. Milstein B, Chapel TJ, Wetterhall SF, Cotton DA. Building capacity for program evaluation at the Centers for Disease Control and Prevention. N Direct Eval. 2002;(93):27-46. Go to original source...
  25. World Health Organization. Raise taxes on tobacco [Internet]. Geneva: WHO; 2008 [cited 2019 Aug 30]. Available from: https://www.who.int/tobacco/mpower/publications/en_tfi_mpower_brochure_r.pdf?ua=1.
  26. Ross H, Blecher E, Yan L, Hyland A. Do cigarette prices motivate smokers to quit? New evidence from the ITC survey. Addiction. 2011 Mar;106(3):609-19. Go to original source... Go to PubMed...
  27. Statista. Retail price of a premium pack of 20 cigarettes in selected European countries in 2017 (in GBP) [Internet]. Hamburg: Consumer Goods & FMCG [cited 2019 Aug 30]. Available from: https://www.statista.com/statistics/415034/cigarette-prices-across-europe/.
  28. World Health Organization. Tobacco [Internet]. Geneva: WHO; 2019 [cited 2018 Mar 9]. Available from: http://www.who.int/en/news-room/fact-sheets/detail/tobacco.
  29. Cheng TL, Johnson SB, Goodman E. Breaking the intergenerational cycle of disadvantage: the three generation approach. Pediatrics. 2016 Jun;137(6). doi: 10.1542/peds.2015-2467. Go to original source... Go to PubMed...
  30. Shirane R, Smith K, Ross H, Silver KE, Williams S, Gilmore A. Tobacco industry manipulation of tobacco excise and tobacco advertising policies in the Czech Republic: an analysis of tobacco industry documents. PLoS Med. 2012;9(6):e1001248. doi: 10.1371/journal.pmed.1001248. Go to original source... Go to PubMed...